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International Journal of Colorectal Disease

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01-12-2016 | Original Article

Risk factors for active bleeding from colonic angiodysplasia confirmed by colonoscopic observation

Authors: Naoyuki Nishimura, Motowo Mizuno, Yuichi Shimodate, Akira Doi, Hirokazu Mouri, Kazuhiro Matsueda, Hiroshi Yamamoto

Published in: International Journal of Colorectal Disease | Issue 12/2016

Abstract

Purpose

Colonic angiodysplasia is an important cause of lower gastrointestinal bleeding in the elderly. Here, we investigated the risk factors for bleeding from colonic angiodysplasia seen at endoscopy.

Methods

We conducted a retrospective case-control study by reviewing records of 435 patients with angiodysplasia at colonoscopy from November 2006 to November 2015 in our hospital. To identify risk factors for active bleeding, the following were analyzed: age, sex, comorbidities, use of antithrombotic drugs and non-steroidal anti-inflammatory drugs, and the size and location of the lesions.

Results

Among the 435 patients, active bleeding from angiodysplasia was observed at endoscopy in 29 patients (6.7 %). Using multivariate analysis, we identified advanced age (odds ratio 5.15, 95 % confidence interval, 1.61–16.5), comorbidity of heart disease (6.88, 1.04–45.5), use of anticoagulant drug (4.22, 1.21–14.7), multiple lesions (6.67, 1.77–25.2), and small lesions (≤5 mm) (17.7, 4.90–64.0) as independent and significant risk factors for active bleeding. Actively bleeding colonic angiodysplasia lesions were very small in most cases (1–2 mm, 24/29, 83 %) and predominantly located in the right-side colon (26/29, 90 %). All of the 29 patients with active bleeding were successfully and safely treated endoscopically, but re-bleeding occurred in nine patients (31 %, 9/29) during the follow-up period of 2–84 months.

Conclusions

Multiple and small colonic angiodysplasia lesions in patients of advanced age, with heart disease, or receiving anticoagulants have increased risk for bleeding. We should be aware that small colonic angiodysplasia lesions in the right-side colon at colonoscopy in these patients may be a source of bleeding.

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Title: Risk factors for active bleeding from colonic angiodysplasia confirmed by colonoscopic observation
Authors: Naoyuki Nishimura
Motowo Mizuno
Yuichi Shimodate
Akira Doi
Hirokazu Mouri
Kazuhiro Matsueda
Hiroshi Yamamoto
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 12/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-016-2651-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Risk factors for active bleeding from colonic angiodysplasia confirmed by colonoscopic observation

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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